1 / 22

Vitamin D Deficiency

Vitamin D Deficiency. Zoe Oliver GPST2 Patch Tutorial. Contents. Aims and Objectives Definitions Rickets/Osteomalacia Risk Factors Natural sources Testing Prescribing AKT questions. Aims and Objectives. Be able to define vitamin D deficiency. Be able to identify those at risk.

colman
Download Presentation

Vitamin D Deficiency

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript

  1. Vitamin D Deficiency Zoe Oliver GPST2 Patch Tutorial

  2. Contents • Aims and Objectives • Definitions • Rickets/Osteomalacia • Risk Factors • Natural sources • Testing • Prescribing • AKT questions

  3. Aims and Objectives • Be able to define vitamin D deficiency. • Be able to identify those at risk. • Have a greater knowledge of the treatment options available. • Be able to advise patients on the appropriate treatment option according to local prescribing guidelines.

  4. Definitions

  5. Rickets/Osteomalacia • Bone has low mineral content – excess uncalcified osteoid and cartilage. • If occurs during period of bone growth ie childhood – Rickets. • If after fusion of epiphyses - Osteomalacia

  6. Rickets Knocked knees Bow legged Thickened wrists/ankles Signs of hypocalcaemia: Tetany Depression Perioral Paraesthesia Carpo-pedal spasm

  7. Osteomalacia Bone Pain Partial Fractures Looser’s Zones Proximal Myopathy Waddling gait

  8. Risk Factors • Pregnant • Breastfeeding • Babies and young children <5 • Older people aged > 65 • Institutions • Dark Skin • Poor sunlight exposure – night shift workers

  9. Vitamin D Requirements Note – I got this table from CKS on vitamin D but the CMO letter says 6 months to 5 years need 7-8.5mcg

  10. Sunlight • During the summer the skin can produce 100 micrograms/day • Possible to build up a store of vitamin D for winter months. • With age, skin becomes thinner and less Vitamin D can be produced.

  11. Vitamin D in Food

  12. Investigation • Vitamin D – RUH £20.50 • Bone Profile • Calcium ↓ • Phosphate ↓ • ALP ↑ • PTH ↑ • X- rays if fractures suspected • Looser's zones are characteristic but not always present • Other Radiological Signs: • crush fractures of the vertebrae • trefoil pelvis • spontaneous fractures of the ribs, pubic rami, femoral neck or the metaphyses above and below the knee • bowing of the long bones • in children - increased depth and width of the epiphyseal growth plate, and a 'cupped' appearance of the adjacent metaphyses

  13. Financial Implications • Expensive test • Testing in RUH up 600% in last 2 years • Vitamin D prescriptions up 16% from 2011 • CMO wrote to GP’s in Jan 2012 urging them to prescribe vitamin D to all at risk groups • Healthy Start vits – see separate talk

  14. AKT Questions

  15. Questions/Discussion

  16. References • BCAP Prescribing • BNF • Passmedicine.com • http://www.cks.nhs.uk/print_preview?pageid=321048000&pagepath=/patient_information_leaflet/osteomalacia_soft_bones_arc/view_as_a_leaflet&rootcontainerelement=nhsd_topicroot&viewtype=full • Pulsetoday.co.uk 22.08.2012 Surge in vitamin D prescribing, Sofia Lind.

More Related